Open Transforaminal Lumbar Interbody Fusion (TLIF) for post-discectomy spondylodiscitis: Our experience
Introduction: Post operative lumbar Spondylodiscitis after lumbar discectomy surgery is well known complication with has a variable incidence rate, usually less than 1%.1 Post op spondylodiscitis is an infection of nucleus pulposus , annulus fibrosis with sometimes secondary involvement of cartilaginous end plates and vertebral bodies following lumbar disc surgeries.2 Early diagnosis of discitis based on clinical, laboratory, radiological findings and appropriate management is essential to reduce morbidity.
Aim: Retrospective review of patients undergoing transforaminal lumbar interbody fusion (TLIF) for post-op discitis to evaluate clinical outcome and complications.
Material and Methods:All patients undergone TLIF for post-lumbar discectomy spondylodiscitis at our institute from sept'13 to sept'17 were included in our study. All patients had moderate to severe lumbar backage. Initialy a course of conservative treatment with broad spectrum I .V antibiotics was given followed by surgery. On follow up patients were assessed with physical examination and radiographs. Outcome were measured in terms of operative time, blood loss, and surgical complications. Parameters like Visual analogue scale(VAS) for pain,modified Rankin scale (mRS) were evaluate before and after surgery and on subsequent follow up visits.
Results: Modified Rankin scale (mRS) and VAS enhanced in all patients.
Conclusion: Postoperative spondylodiscitis can be successfully managed with transforaminal lumbar interbody fusion (TLIF) and posterior spinal instrumentation. There is significant pain relief and good functional outcome after surgery.
Keywords: Spondylodiscitis, Post discectomy infection, Transforaminal Lumbar Interbody Fusion (TLIF), Lumbar disc infection.